Substance use disorder affects all different types of people, from kids in high school to professionals in high-paying, corporate jobs. Addictions of all kinds destroy families, friendships, and careers. If you have a problem with a substance use disorder, you're not alone in your battle to be drug-free. With different types of treatment available, you can join others in recovery and get your life back on track.
You may have already tried to stop using drugs a number of times, only to go back when the craving became too intense. That is because you can become both physically and psychologically addicted.
On a physical level, continually putting the drug into your system causes changes to brain chemistry. You may become tolerant and need higher and higher doses to feel the same effect. If you were to suddenly stop taking it, your body goes into withdrawal. Depending on which drug you are addicted to, you may have a range of symptoms—tremors, stomach cramps, vomiting, nausea, diarrhea, chills, insomnia, and restlessness.
Psychologically, you may feel that you cannot function without the drug, and being stressed may make you want to use the drug even more. Your time may be spent around friends who are also using drugs, which only encourages you to continue the habit. Quitting can trigger an extreme desire for the drug and can lead to feelings of depression, paranoia, anxiety, agitation, and aggression.
All of these factors work against you in your fight to be drug-free. Also, you may not just be dealing with the addiction itself, but also with an underlying mental health issue (such as depression, anxiety, or post-traumatic stress disorder), interpersonal conflicts, unemployment, and health problems. That is why it becomes so important for you to get professional help.
Treatment usually depends on what drug you are addicted to and what other problems you are facing. Look for a program that can address all of your issues, views you as an individual, and changes as your needs change. In most cases, you will want a combination of care from medical doctors, psychologists and drug abuse counselors, and case managers.
Treatment starts with detoxification. Under the care of your doctor, you need to go through a process where you rid the drug from your body. Medication can help ease the withdrawal symptoms. Depending on the drug, these symptoms can last several days, but you still have the long-term changes to your brain function, as well as the psychological effects. While some people think that all they need to do is go through detox to overcome addiction, treatment means a long-term commitment to change your lifestyle and behavior. Detox is just the first step.
In most cases, treatment involves both therapy and medication. In therapy, you learn how to deal with cravings and how to identify your drug abuse patterns. Are there certain situations where you are more likely to use drugs? What are the best ways to cope with these situations? How can you prevent relapse? If you do relapse, how do you recover?
By working with a therapist, you slowly change your thinking and behavior, and build skills to sustain a drug-free lifestyle. This also involves working through any underlying issues that you have, like abuse or neglect, which may have led to the use of drugs. If you have a dual-diagnosis, such as addiction and depression, you will need to be treated for both conditions, ideally at the same time.
Medication also plays a role in your recovery. For example, if you are addicted to heroin, your treatment might involve taking daily doses of methadone, which can help reduce your cravings, increase your chance of staying in the rehab program, and stabilize your behavior. Other medications, like antidepressants and mood stabilizers (for bipolar disorder), may also be prescribed if you have mental health issues. In addition, if you are diagnosed with a medical condition, such as hepatitis B, your doctor will treat this as well.
Treatment can take place on an outpatient or inpatient (residential) basis; the choice really depends on your situation.
Outpatient programs may be a good choice if your addiction is not as severe, you are still able to work, and you have a good support system. These programs can vary greatly from drug education and counseling to more comprehensive and intense programs that address multiple needs. In general, you can expect to be involved in both one-on-one sessions and group therapy.
Behavioral therapy, family therapy, and motivational interviewing (a counseling style that focuses on changing your behavior) are some of the approaches that are typically used. Over time, you will become more accustomed to expressing your emotions and sharing your stories. You will work on the issues surrounding your addiction and learn new skills to handle situations where you normally would use drugs. This may involve doing assignments given to you by your therapist, role playing, going over your progress, and earning privileges for working toward your goals. You can also expect to confront relationship and family problems, which can impact your recovery.
Inpatient or residential programs can be short-term or long-term. These programs are better suited for people who have a severe addiction, have difficulty functioning, or have a criminal record. If you are facing these circumstances, then your chances of recovery are better if you are removed from situations where you typically use drugs.
The most structured type of program is called therapeutic community, which basically means that you learn how to function again by being part of the community. You work with the staff and other members in the program to change your behavior and thinking and to learn new skills and values. This involves a huge commitment on your part. You have to take responsibility for your own recovery and be involved in others’ recovery too. This may mean that you do a 12-step program, like Narcotics Anonymous, where you advance through steps to overcome your addiction and help others to do the same.
Whether you choose inpatient or outpatient, find a program that views you as an individual and takes into account many factors, like your age, gender, family situation, health status, sexual orientation, ability to work, and financial standing.
If you have private health insurance, check your policy. If you have chosen a facility, talk to the staff to make sure they accept your insurance. You will also need to know how much the program costs, what your insurance will cover, and whether you need pre-authorization.
If you have insurance through Medicare or Medicaid, the government may pay for outpatient and inpatient treatment, but there may be certain restrictions, such as going to a participating facility, getting a referral from your doctor, and having a treatment plan from your doctor. Check with your state to find out where you can go for treatment and for how long.
In some cases, people without insurance pay out-of-pocket or rely on family members and friends. But treatment is very expensive. Some places do have a sliding fee scale (based on your income) and payment assistance.
There are government-funded facilities if you have no insurance and financial problems. Keep in mind, though, that these often have long waiting lists, sometimes as long as several months. If you need help in finding a facility near you, call the Substance Abuse & Mental Health Services Administration at 1-800-662-HELP.
For treatment to be effective, you may need to participate in a program for several months to over a year. Staying in a program is affected by how motivated you are to change and how much support you get from family and friends. You may also feel pressured to stay in treatment because of problems with the law or with your job. Even if you are severely addicted, you can recover by actively participating in therapy.
Substance use disorder is a chronic condition. Sometimes it takes several attempts before you are truly able to live a drug-free life. That is why aftercare becomes just as important as the treatment program itself. You have many goals—to be healthy, to have a place to live, to work again, to rebuild relationships, and so on. To achieve these, you’ll work with a case manager who will oversee your ongoing care and get you the services that you need, whether it is housing assistance, vocational training, or family therapy. Remember, successful recovery from drug addiction is a process that requires help from others—friends, family, and professionals. You are not alone. There is hope, help, and healing.
National Institute on Drug Abuse
Substance Abuse & Mental Health Services Administration
Canadian Centre on Substance Abuse
Drug Rehab and Drug Addiction Treatment
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Last reviewed July 2016 by Michael Woods, MD Last Updated: 7/22/2016